How Are Hiatal Hernias Treated?

Most people do not experience any symptoms of their hiatal hernia so no treatment is necessary. However, the paraesophaeal hernia (when part of the stomach squeezes through the hiatus) can sometimes cause the stomach to be strangled, so surgery is sometimes recommended. Other symptoms that may occur along with the hernia such as chest pain should be properly evaluated. Symptoms of GERD, such as heartburn, should be treated.

When Is Hiatal Hernia Surgery Necessary?

If the hiatal hernia is in danger of becoming constricted or strangulated (so that the blood supply is cut off), surgery may be needed to reduce the hernia, meaning put it back where it belongs.

Hiatal hernia surgery can often be performed as a laparoscopic, or "minimally invasive," procedure. During this type of surgery, a few small (5 to 10 millimeter) incisions are made in the abdomen. The laparoscope that allows the surgeon to see inside the abdomen and surgical instruments are inserted through these incisions. The surgeon is guided by the laparoscope, which transmits a picture of the internal organs to a monitor. The advantages of laparoscopic surgery include smaller incisions, less risk of infection, less pain and scarring, and a more rapid recovery.

Many patients are able to walk around the day after hernia surgery. Generally, there are no dietary restrictions and the patient can resume his or her regular activities within a week. Complete recovery will take two to three weeks, and hard labor and heavy lifting should be avoided for at least three months after surgery. Unfortunately, there is no guarantee, even with surgery, that the hernia will not return.

When Should I Call the Doctor About a Hiatal Hernia?

If you have been diagnosed with a hiatal hernia and you develop severe pain in the chest or abdomen, become nauseated, are vomiting, or are unable to have a bowel movement or pass gas, you may have a strangulated hernia or an obstruction, which are medical emergencies. Call your doctor immediately.